Socioeconomic factors and the evaluation of HIV/AIDS prevention programs: A psychometric analysis of an instrument
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Department of Educational Foundations, University of Calabar, Calabar, NIGERIA
Ultimate Research Network, Calabar, NIGERIA
Department of Human Kinetics and Health Education, University of Calabar, Calabar, NIGERIA
Department of Vocational Education, University of Calabar, Calabar, NIGERIA
Publication date: 2022-08-09
Electron J Gen Med 2022;19(6):em405
Research has documented the prevalence of different HIV/AIDS prevention programs launched to reduce the spread of the virus. However, the extent to which the success or otherwise of these programs are achieved is rarely discussed. This study addresses this gap by analyzing the impact of three socioeconomic parameters on the evaluation of HIV/AIDS prevention programs in the Southern Senatorial District of Cross River State, Nigeria.

A sample of 239 health care employees selected using the proportional stratified random sampling technique participated in the study. A priori power analysis (using G*power) indicated that the sample size was large enough to achieve a 96.7% statistical power. Data was collected using a structured questionnaire. Exploratory factor analysis assessed the dimensionality of the instrument. Acceptable construct and discriminant validity and composite reliability coefficients were obtained. At the .05 alpha level, the null hypotheses were tested using a one-way analysis of variance.

Findings indicated that the evaluation of HIV/AIDS prevention programs significantly varied with the level of funding provided (F[2, 236]=81.11, p<.001), human capacity available (F[2, 236]=40.91, p<.001), and stigmatization to people living with AIDS (F[2, 236]=40.79, p<.001). Health facilities with higher funding and human capacity successfully evaluated HIV/AIDS prevention programs. However, the evaluation of HIV/AIDS prevention programs was lower in areas with a high level of stigmatization.

Conclusion and implication:
This study’s findings provided evidence that funding, human capacity, and stigmatization affect how HIV/AIDS pandemic can be effectively evaluated. This study implies that additional responsibility is required for public health workers to promote quality service delivery across different health facilities.

United Nations (UN). The 17 goals: Sustainable development goals. Department of Economic and Social Affairs. United Nations. 2022. Available at: https://sdgs.un.org/goals (Accessed: 24 June 2022).
Williams MS, Poteat T, Bender M, Ugwu P, Burns PA. Revitalising HIV prevention programs: Recommendations from those most impacted by HIV in the Deep South. Am J Heal Promot. 2022;36:155-64. https://doi.org/10.1177/089011... PMid:34409888.
Gardner AJ, Fisher M, Tribit GK, Little CE, Lucas ED, Lowe M-RT. Research brief: Assessing readiness for barbershop-based HIV prevention programs among rural African American barbershop patrons. Fam Community Health. 2022;45:103-7. https://doi.org/10.1097/FCH.00... PMid:35125485.
Koenig LJ, Lyles CM, Higa D, Mullins MM, Sipe TA. Research synthesis, HIV prevention response, and public health: CDC’s HIV/AIDS prevention research synthesis project. Public Health Rep. 2022;137:32-47. https://doi.org/10.1177/003335... PMid:33635724.
Owan VJ, Akah LU, Ogbeche MM, Obla ME. Professional variables and staff readiness to utilise internet-based channels for research communication in an Era of Covid-19. Libr Philos Pract 2021;2021:5863. https://doi.org/10.21203/rs.3.... PMCid:PMC8700052.
Owan VJ, Uzoamaka Duruamaku-Dim J, Nonyelum Odigwe F, Owan MV. Dataset of the adoption of digital tools for research sharing among academics in African Varsities during the COVID-19 pandemic in 2020. F1000Research 2022;11:82. https://doi.org/10.12688/f1000... PMid:35529275 PMCid:PMC904690.
Gall J, Sabin K, Frescura L, Sabin ML, Erkkola T, Toskin I. Global trends of monitoring and data collection on the HIV Response among key populations since the 2001 UN declaration of commitment on HIV/AIDS. AIDS Behav. 2017;21:34-43. https://doi.org/10.1007/s10461... PMid:27896550.
Juárez Figueroa LA, Uribe-Salas FJ, González-Rodríguez A, Iracheta-Hernández P, Ruiz-González V, Medina-Islas Y. Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City. Salud Publica Mex. 2017;59:147-53. https://doi.org/10.21149/8072 PMid:28562715.
Teh CH, Teh MW, Lim KH, et al. Clustering of lifestyle risk behaviours and its determinants among school-going adolescents in a middle-income country: A cross-sectional study. BMC Public Health. 2019;19:1177. https://doi.org/10.1186/s12889... PMid:31455283 PMCid:PMC6712662.
Pretorius E, Klinker H, Rosenkranz B. The role of therapeutic drug monitoring in the management of patients with human immunodeficiency virus infection. Ther Drug Monit. 2011;33:265-74. https://doi.org/10.1097/FTD.0b... PMid:21566505.
Schneider MT, Birger M, Haakenstad A, et al. Tracking development assistance for HIV/AIDS. AIDS. 2016;30:1475-9. https://doi.org/10.1097/QAD.00... PMid:26950317 PMCid:PMC4867985.
Sekimitsu S, DePasse J, Morrison M, et al. High variability in the measurement of HIV primary prevention activities and outcomes. J Int AIDS Soc. 2020;23:e25645. https://doi.org/10.1002/jia2.2... PMid:33345450 PMCid:PMC7750494.
Vannakit R, Andreeva V, Mills S, et al. Fast-tracking the end of HIV in the Asia Pacific region: Domestic funding of key population-led and civil society organisations. Lancet HIV. 2020;7:e366-72. https://doi.org/10.1016/S2352-....
Kates J, Dawson L, Horn TH, et al. Insurance coverage and financing landscape for HIV treatment and prevention in the USA. Lancet. 2021;397:1127-38. https://doi.org/10.1016/S0140-....
Lyu T, Qiao S, Hair N, Liang C, Li X. Federal funding allocation on HIV/AIDS research in the United States (2008-2018): An exploratory study using big data. AIDS Care. 2021:1-7. https://doi.org/10.1080/095401... PMid:33682543.
Obi US, Ogbuoji O, Mao W, Shahid M, Onwujekwe O, Yamey G. Progress in the face of cuts: A qualitative Nigerian case study of maintaining progress towards universal health coverage after losing donor assistance. Health Policy Plan. 2021;36:1045-57. https://doi.org/10.1093/heapol... PMid:33942865 PMCid:PMC8359748.
Oladele TT, Olakunde BO, Oladele EA, Ogbuoji O, Yamey G. The impact of COVID-19 on HIV financing in Nigeria: A call for proactive measures. BMJ Glob Heal. 2020;5:e002718. https://doi.org/10.1136/bmjgh-... PMid:32434777 PMCid:PMC7246094.
Bulstra CA, Reddy CL, Atun R, Bärnighausen T, Hontelez JAC. Impact of the coronavirus disease 2019-related global recession on the financing of the global HIV response. AIDS. 2021;35:1143-6. https://doi.org/10.1097/QAD.00... PMid:33710025.
Joint United Nations Programme on HIV/AIDS (UNAIDs). UNAIDS annual report 2009. United Nations Program HIV/AIDS. 2009. Available at: https://bit.ly/3svieN8 (Accessed: 24 July 2022).
Tso LS, Best J, Beanland R, et al. Facilitators and barriers in HIV linkage to care interventions. AIDS. 2016;30:1639-53. https://doi.org/10.1097/QAD.00... PMid:27058350 PMCid:PMC4889545.
Kanyamuna V, Phiri M, Kanenga H, Mulonda M. Role of actors outside government in strengthening the country monitoring and evaluation system in Zambia. World J Soc Sci Humanit. 2022;6:22-9.
Magnus M, Herwehe J, Murtaza-Rossini M, et al. Linking and retaining HIV patients in care: The importance of provider attitudes and behaviors. AIDS Patient Care STDS. 2013;27:297-303. https://doi.org/10.1089/apc.20... PMid:23651107 PMCid:PMC3651678.
Craveiro I, Dussault G. The impact of global health initiatives on the health system in Angola. Glob Public Health. 2016;11:475-95. https://doi.org/10.1080/174416... PMid:26758687.
Moon TD, Burlison JR, Blevins M, et al. Enrolment and programmatic trends and predictors of antiretroviral therapy initiation from President’s Emergency Plan for AIDS Relief (PEPFAR)-supported public HIV care and treatment sites in rural Mozambique. Int J STD AIDS. 2011;22:621-7. https://doi.org/10.1258/ijsa.2... PMid:22096045.
Cohen J. HIV/AIDS: India’s many epidemics. Science. 2004;304:504-9. https://doi.org/10.1126/scienc... PMid:15105469.
Nyblade L, MacQuarrie K, Phillip F, et al. Measuring HIV Stigma: Results of a field test in Tanzania. 2005.
Inzaule SC, Hamers RL, Doherty M, Shafer RW, Bertagnolio S, Rinke de Wit TF. Curbing the rise of HIV drug resistance in low-income and middle-income countries: The role of dolutegravir-containing regimens. Lancet Infect Dis. 2019;19:e246-52. https://doi.org/10.1016/S1473-....
Nxumalo CT, Mchunu GG. Exploring the stigma related experiences of family members of persons with mental illness in a selected community in the iLembe district, KwaZulu-Natal. Heal SA Gesondheid. 2017;22:202-12. https://doi.org/10.1016/j.hsag....
Lee S, Kim EY, Chang SO. A life where concealment and exposure coexist-The antiretroviral therapy adherence of people living with HIV infection: A phenomenological study. J Adv Nurs. 2020;76:1027-36. https://doi.org/10.1111/jan.14... PMid:32003040.
Oke OO, Akinboro AO, Olanrewaju FO, Oke OA, Omololu AS. Assessment of HIV-related stigma and determinants among people living with HIV/AIDS in Abeokuta, Nigeria: A cross-sectional study. SAGE Open Med. 2019;7:205031211986910. https://doi.org/10.1177/205031... PMid:31448118 PMCid:PMC6689915.
Belden M, Reif S, Cooper H, et al. The geographic reach of community-based organisations in addressing HIV-related stigma in the Deep South. AIDS Care. 2022;34:60-8. https://doi.org/10.1080/095401... PMid:34632864.
Nyaga R. The HIV/AIDS pandemic in Kenya: An investigation into the perceptions of Kenyans toward people living with HIV/AIDS and government programs. African J AIDS Res. 2020;19:117-22. https://doi.org/10.2989/160859... PMid:32780680.
Bhanot D, Singh T, Verma SK, Sharad S. Stigma and discrimination during COVID-19 pandemic. Front Public Heal. 2021;8:577018. https://doi.org/10.3389/fpubh.... PMid:33585379 PMCid:PMC7874150.
Baugher AR, Beer L, Fagan JL, et al. Prevalence of internalised HIV-related stigma among HIV-infected adults in care, United States, 2011-2013. AIDS Behav. 2017;21:2600-8.https://doi.org/10.1007/s10461... PMid:28213821 PMCid:PMC5555833.
Li Z, Hsieh E, Morano JP, Sheng Y. Exploring HIV-related stigma among HIV-infected men who have sex with men in Beijing, China: A correlation study. AIDS Care. 2016;28:1394-401. https://doi.org/10.1080/095401... PMid:27137205 PMCid:PMC5069196.
Earnshaw VA, Bogart LM, Dovidio JF, Williams DR. Stigma and racial/ethnic HIV disparities: Moving toward resilience. Stigma Heal. 2015;1:60-74. https://doi.org/10.1037/2376-6....
Rice WS, Crockett KB, Mugavero MJ, Raper JL, Atkins GC, Turan B. Association between internalised HIV-related stigma and HIV care visit adherence. JAIDS J Acquir Immune Defic Syndr. 2017;76:482-7. https://doi.org/10.1097/QAI.00... PMid:28885270 PMCid:PMC5680126.
Sweeney SM, Vanable PA. The association of HIV-related stigma to HIV medication adherence: A systematic review and synthesis of the literature. AIDS Behav. 2016;20:29-50. https://doi.org/10.1007/s10461... PMid:26303196.
Ha JH, Van Lith LM, Mallalieu EC, et al. Gendered relationship between HIV stigma and HIV testing among men and women in Mozambique: A cross-sectional study to inform a stigma reduction and male-targeted HIV testing intervention. BMJ Open. 2019;9:e029748. https://doi.org/10.1136/bmjope... PMid:31594877 PMCid:PMC6797434.
Sullivan MC, Rosen AO, Allen A, et al. Falling short of the first 90: HIV stigma and HIV testing research in the 90-90-90 Era. AIDS Behav. 2020;24:357-62. https://doi.org/10.1007/s10461... PMid:31907675.
Balaji AB, Bowles KE, Hess KL, Smith JC, Paz-Bailey G. Association between enacted stigma and HIV-related risk behavior among MSM, national HIV behavioral surveillance system, 2011. AIDS Behav. 2017;21:227-37. https://doi.org/10.1007/s10461... PMid:27830344.
Nelson LE, Wilton L, Agyarko-Poku T, et al. The association of HIV stigma and HIV/STD knowledge with sexual risk behaviors among adolescent and adult men who have sex with men in Ghana, West Africa. Res Nurs Health. 2015;38:194-206. https://doi.org/10.1002/nur.21... PMid:25809638.
Klopper C, Stellenberg E, van der Merwe A. Stigma and HIV disclosure in the Cape Metropolitan area, South Africa. African J AIDS Res. 2014;13:37-43. https://doi.org/10.2989/160859... PMid:25174514.
Logie CH, Newman PA, Weaver J, Roungkraphon S, Tepjan S. HIV-related stigma and HIV prevention uptake among young men who have sex with men and transgender women in Thailand. AIDS Patient Care STDS. 2016;30:92-100. https://doi.org/10.1089/apc.20... PMid:26788978.
Oldenburg CE, Perez-Brumer AG, Hatzenbuehler ML, et al. State-level structural sexual stigma and HIV prevention in a national online sample of HIV-uninfected MSM in the United States. AIDS. 2015;29:837-45. https://doi.org/10.1097/QAD.00... PMid:25730508 PMCid:PMC4439297.
Malama K, Kilembe W, Inambao M, et al. A couple-focused, integrated unplanned pregnancy and HIV prevention program in urban and rural Zambia. Am J Obstet Gynecol. 2020;222:S915.e1-S915.e10. https://doi.org/https://doi.or... PMid:31945337 PMCid:PMC8377731.
Operario D, Gamarel KE, Iwamoto M, et al. Couples-focused prevention program to reduce HIV risk among transgender women and their primary male partners: Feasibility and promise of the couples HIV intervention program. AIDS Behav. 2017;21:2452-63. https://doi.org/10.1007/s10461... PMid:27334464 PMCid:PMC5179320.
Cartagena RG, Veugelers PJ, Kipp W, Magigav K, Laing LM. Effectiveness of an HIV prevention program for secondary school students in Mongolia. J Adolesc Heal. 2006;39:925.e9-925.e16. https://doi.org/10.1016/j.jado... PMid:17116526.
Espada JP, Orgilés M, Morales A, Ballester R, Huedo-Medina TB. Effectiveness of a school HIV/AIDS prevention program for Spanish adolescents. AIDS Educ Prev. 2012;24:500-13. https://doi.org/10.1521/aeap.2... PMid:23206200.
Akah LU, Ekpo AJ, Owan VJ. Care/support, location, and the monitoring/evaluation of HIV/AIDs prevention programs: The case of Southern Senatorial District of Cross River State, Nigeria. Int J Interdiscip Educ Stud 2022;17:115-35. https://doi.org/10.18848/2327-....
Dittus P, Miller KS, Kotchick BA, Forehand R. Why parents matter! The conceptual basis for a community-based HIV prevention program for the parents of African American youth. J Child Fam Stud. 2004;13:5-20. https://doi.org/10.1023/B:JCFS....
Wang B, Deveaux L, Cottrell L, et al. The effectiveness of two implementation strategies for improving teachers’ delivery of an evidence-based HIV prevention program. Prev Sci. 2022. https://doi.org/10.1007/s11121... PMid:35064894 PMCid:PMC9304446.
Agathis NT, Annor FB, Coomer R, et al. HIV prevention program eligibility among adolescent girls and young women-Namibia, 2019. MMWR Morb Mortal Wkly Rep. 2021; 70:1570-4. https://doi.org/10.15585/mmwr.... PMid:34758009 PMCid:PMC8580202.
Ybarra ML, Agaba E, Chen E, Nyemara N. Iterative development of in this toGether, the first mHealth HIV prevention program for older adolescents in Uganda. AIDS Behav. 2020;24:2355-68. https://doi.org/10.1007/s10461... PMid:32072385.
Ali A. Conducting research in education and the social sciences. Enugu: Tashiwa Networks Ltd.; 2006.
Cross River State Ministry of Health (CRSMH). Operational plan for the elimination of mother-to-child transmission of HIV (Cross River State 2015-2030). Calabar: 2021.
Erdfelder E, FAul F, Buchner A, Lang AG. Statistical power analyses using G*power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149-60. https://doi.org/10.3758/BRM.41... PMid:19897823.
Faul F, Erdfelder E, Lang AG, Buchner A. G*power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91. https://doi.org/10.3758/BF0319... PMid:17695343.
Cohen J. Statistical power analysis for the behavioural sciences. New York: Lawrence Erlbaum Associates, Publishers; 1988.
Uakarn C. Sample size estimation using Yamane and Cochran and Krejcie and Morgan and Green formulas and Cohen statistical power analysis by G*power and comparisons. Apheit Int J. 2021;10:76-88.
Hadi HJ, Omar MA, Osman WRS, Ibrahim MF, Hussaini M. Performing a content validity: Establishing a reliable instrument to measure the intention to adopt cloud computing software as a service in public organisation. J Theor Appl Inf Technol. 2020;98:3531-40.
Lawshe CH. A quantitative approach to content validity. Pers Psychol. 1975;28:563-75. https://doi.org/10.1111/j.1744....
Zamanzadeh V, Rassouli M, Abbaszadeh A, Majd HA, Nikanfar A, Ghahramanian A. Details of content validity and objectifying it in instrument development. Nurs Pract Today. 2015;1:163-71.
Owan VJ, Odigwe FN, Okon AE, Duruamaku-Dim JU, Ubi IO, Emanghe EE, et al. Contributions of placement, retraining and motivation to teachers' job commitment: structural equation modelling of the linkages. Heliyon 2022;8:e09334. https://doi.org/10.1016/j.heli... PMid:35520624 PMCid:PMC9062217.
Owan VJ, Ekpenyong JA, Asuquo ME. A structural equation model of principals' communication patterns, funds management and school-community relationship. J Pedagog Sociol Psychol 2021;3:1-18. https://doi.org/10.33902/JPSP.....
Ab Hamid MR, Sami W, Mohmad Sidek MH. Discriminant validity assessment: Use of Fornell & Larcker criterion versus HTMT criterion. J Phys Conf Ser. 2017;890:12163. https://doi.org/10.1088/1742-6....
Fornell C, Larcker DF. Structural equation models with unobservable variables and measurement error: Algebra and statistics. J Mark Res. 1981;18:382-8. https://doi.org/10.1177/002224....
Henseler J, Ringle CM, Sarstedt M. A new criterion for assessing discriminant validity in variance-based structural equation modeling. J Acad Mark Sci. 2015;43:115-35. https://doi.org/10.1007/s11747....
Owan VJ, Emanghe EE, Denwigwe CP, Etudor-Eyo E, Usoro AA, Ebuara VO, et al. Curriculum management and graduate programmes' viability: The mediation of institutional effectiveness using PLS-SEM approach. J Curric Teach 2022;11:114-27. https://doi.org/10.5430/jct.v1....
Nigeria’s National Agency for the Control of AIDs (NACA). The national HIV and AIDS monitoring and evaluation plan 2011-2016. Abuja: NACA; 2011.
Aguanno RD, Lamielle G, von Dobschuetz S, Dhingra M. The power of evaluations: One year review of FAO’s surveillance evaluation tool (SET) and tracking future impacts. Int J Infect Dis. 2019;79:110-1. https://doi.org/10.1016/j.ijid....
World Health Organisation (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDs). HIV/AIDS prevention, care, treatment and support in prison settings: A framework for an effective national response. New York: United Nations; 2006. Available at: https://www.unodc.org/pdf/HIV-... (Accessed: 7 August 2022).
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